The holder whose full name is Bloebaum, Lisa Michelle,come from Vincennes IN,hold the Pharmacy Intern license(NO.45011816A) which status is Superceded.
| Name | Bloebaum, Lisa Michelle |
|---|---|
| License Number | 45011816A |
| License Type | Pharmacy Intern |
| License Status | Superceded |
| City | Vincennes |
| State | IN |